Details

Autor(en) / Beteiligte

• Van Oekelen, Oliver
• Parekh, Samir
• Cho, Hearn J.
• Vishnuvardhan, Nivetha
• Madduri, Deepu
• Richter, Joshua
• Ip, Chun
• Lau, Kenneth
• Florendo, Erika
• Mancia, Ines S.
• Thomas, Joanne
• Verina, Daniel
• Chan, Elaine
• Zarychta, Katarzyna
• La, Lisa
• Strumolo, Gina
• Melnekoff, David T.
• Leshchenko, Violetta V.
• Kim-Schulze, Seunghee
• Couto, Suzana
• Wang, Maria
• Pierceall, William E.
• Thakurta, Anjan
• Laganà, Alessandro
• Jagannath, Sundar
• Chari, Ajai

Titel

A phase II study of pomalidomide, daily oral cyclophosphamide, and dexamethasone in relapsed/refractory multiple myeloma

Ist Teil von

• Leukemia & lymphoma, 2020-07, Vol.61 (9), p.2208-2215

Ort / Verlag

United States: Taylor & Francis

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Relapsed/refractory multiple myeloma patients treated with pomalidomide and dexamethasone have an overall response rate (ORR) of ∼30% and median progression-free survival (PFS) of 4-5 months. Previous studies explored addition of weekly cyclophosphamide, but we hypothesized that daily dosing allows for better synergy. We report the open-label, single-center phase II study of pomalidomide, daily cyclophosphamide and weekly dexamethasone (PCD). Thirty-three patients were evaluable for efficacy and underwent 28-day cycles of pomalidomide (4 mg/day, D1-21), cyclophosphamide (50 mg b.i.d., D1-21) and weekly dexamethasone. All were lenalidomide-refractory and 55% were refractory to lenalidomide and proteasome inhibitor. ORR was 73%; median PFS and overall survival were 13.3 months and 57.2 months respectively. Grade 3/4 toxicities were primarily hematologic but manageable with dose reductions. Early disease progression correlated with MYC expression and flow cytometry demonstrates an activated microenvironment post-PCD. Addition of metronomic cyclophosphamide to pomalidomide and dexamethasone is a cost-effective, oral regimen with encouraging PFS.